T cells and in situ cryoglobulin deposition in the pathogenesis of lupus nephritis

Clin Immunol. 2008 Jul;128(1):1-7. doi: 10.1016/j.clim.2008.04.004.


We discuss a 53-year-old woman with systemic lupus erythematosus who presented with vasculitis, hypocomplementemia and nephritis. Although her serum complement 4 (C4) levels were zero, she had four copies of C4 gene. Renal biopsy revealed membranoproliferative glomerulonephritis and the presence of cryoglobulins, detected by electron microscopy, and significant numbers of T cells in the interstitium. Cryoglobulins were considered responsible for the complete consumption of C4 in the serum the levels of which improved gradually after treatment. T cells in the kidney were found to express CD44 and phosphorylated ezrin/radixin/moiesin which explain why they homed to the kidney inappropriately. The contribution of cryoglobulins and T cells in the expression of kidney pathology is discussed.

Publication types

  • Case Reports

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Complement C4 / deficiency
  • Cryoglobulins / metabolism*
  • Female
  • Fluorescent Antibody Technique
  • Humans
  • Hyaluronan Receptors / metabolism
  • Lupus Nephritis / immunology*
  • Lupus Nephritis / pathology*
  • Lupus Nephritis / physiopathology*
  • Microscopy, Electron, Transmission
  • Middle Aged
  • Mycophenolic Acid / analogs & derivatives
  • Mycophenolic Acid / therapeutic use
  • Prednisone / therapeutic use
  • T-Lymphocytes / immunology*
  • T-Lymphocytes / metabolism


  • Anti-Inflammatory Agents
  • CD44 protein, human
  • Complement C4
  • Cryoglobulins
  • Hyaluronan Receptors
  • Mycophenolic Acid
  • Prednisone